AB0577 CLINICAL MANIFESTATIONS AND VARIANTS OF THE COURSE OF TAKAYASU ARTERITIS IN A KYRGYZ COHORT
Authors: G. Koilubaeva, A. Bolotbekova
Journal: Annals of the Rheumatic Diseases (2022)

Background The lack of a unified clinical classification and standardized methods of diagnosis creates additional difficulties for timely verification of the diagnosis in real clinical practice. According to a number of studies, there are some differences in phenotypic manifestations among patients with Takayasu arteritis (TAK) of different ethnicity, which determined the objectives of this study. Objectives To study the features of the course of the TAK in the Kyrgyz cohort (KC) of patients. Methods The angiographic classification of R. Moriwaki et al. was used to determine the anatomical type of vascular bed lesion [1]. The TAK activity was evaluated according to BVAS index, developed by R. Luqmani et al. R. [2], Jefferson’s classification was used to characterize the clinical stage of TAK [3]. K. Ishikawa’s classification was used to detect the severity of complications and assess the forecast of the disease [6]. All patients underwent a standard laboratory tests, with the mandatory determination of highly sensitive CRP (hs-CRP) and interleukin 6 (IL6). Degree of peripheral vessels lesion was assessed according to data from Duplex Doppler ultrasound scanning of arteries in the color Doppler imaging mode. Results The study included 130 patients who were diagnosed with TAK, verified according to criteria of the American College of Rheumatology (ACR, 1990) [4,5] and who received treatment at the NCCIM from January 2014 to November 2021. The majority of patients were women (93.08%), of Kyrgyz nationality (90.77%), of young age - 32 years old [23; 41], with a disease duration of 6.5 years [3.0; 11.0], with the onset of the disease at the age of 23 [18; 31]. By anatomical type of vascular lesion, the patients were distributed as follows: type I was detected in 18 (13.85%), II (a and b) - in 24 (18.46%) patients, III - in 2 (1.54 %), IV - in 5 (3.85%) and V - in 81 (63.3%) patients, which indicated the prevalence of generalized and diffuse lesions of all parts of aorta. According to the BVAS index, most patients had a severe exacerbation - 74 cases (57%), mild exacerbation observed slightly less (42 cases or 32.3%), partial remission occurred in 13 cases (10%) and complete remission in only 1 case (0,77%). By clinical classification, the majority of patients (119 or 91.54%) had vascular stage; none of the patients had the criteria for the prevasculitis stage. In the overwhelming majority of patients (43.84%) nature of vascular lesion was represented by isolated stenosis while a combination of stenosis with occlusive changes was observed in almost 40% of patients. Conclusion In the KC of patients with TAK, the overwhelming majority of cases was among women (90.77%) of young age with the onset of the disease at 23 years. Generalized lesions of the arterial bed (63.3%) and severe exacerbation (57%) were mainly observed. The vascular stage predominated (in 91.54% of cases), with the prevalence of stenotic and occlusive changes (40%). References [1]Moriwaki R., Noda M., Yajima M. et al. Clinical manifestations of Takayasu arteritis in India and Japan — new classification of angiographic findings. Angiology, 1997; 48 (5): 369–379. [2]Luqmani R. Evaluation of vasculitis disease activity in Europe. Eur J Intern Med., 2007; 66 (3): 283-292. [3]Jefferson R., Roberts M.D. et al. Takayasu Arteritis Differential Diagnoses. Medscape-2016 URL: http://emedicine.medscape.com/article/332378-differential . [4]Arend W.P., Michel B.A., Bloch D.A., et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum., 1990; 33(8): 1129–1134. [5]Sharma B.K., Jain S., Suri S. et al. Diagnostic criteria for Takayasu arteritis. Int. J. Cardiol. , 1996; 54:141–S147. [6]Ishikawa K. Natural history and classification of occlusive thromboaortopathy (Takayasu’s disease). Circulation , 1978; 57 (1):27–35. Disclosure of Interests None declared